Digital Independence Linked to Functional Independence among Adults with Intellectual Disability
Theja Kuruppu Arachchi, Laurianne Sitbon, Jinglan Zhang, Stewart Koplick, Maria Hoogstrate, Margot Brereton · 2025 · ACM Transactions on Accessible Computing · doi:10.1145/3774932
Summary
This study investigates the relationship between digital independence (the ability to access and use digital technologies for information) and functional independence (the ability to perform daily living tasks) among adults with intellectual disability. The researchers recruited 39 participants aged 19-59 from a disability service organization in Australia, all of whom could verbally communicate their daily experiences. Rather than relying on traditional IQ-based classifications, the study uses observable behaviors—specifically independence in four shopping-related activities—as proxies for executive function: keeping the home safe when leaving (locking doors and windows), choosing items to buy, handing over the correct amount of money, and paying by credit card. Data was collected through structured interviews using an accessible survey designed with simple language, pictures, and visual supports to minimize cognitive load. The survey covered health information interests, preferred information sources (doctors, books/magazines, internet/YouTube, chemists), internet use frequency and location, sources of support for internet access, and independence in shopping tasks. The researchers employed a two-phase cluster analysis approach—agglomerative hierarchical clustering followed by k-means clustering—to identify natural groupings among participants based on their information-seeking habits, educational attainment, and functional independence.
Key findings
The k-means cluster analysis identified two distinct participant clusters with homogeneous characteristics. Cluster 1 contained 24 participants who had completed only special school education, were not independent in all four shopping-related functions, sought health information primarily from doctors, and did not use the internet, print materials, or chemists for health information. Cluster 2 contained 15 participants who had completed vocational or technical training, were independent in all four shopping functions, and accessed health information from the internet and chemists in addition to doctors. A striking finding was that 69% of participants used the internet daily, primarily at home (72%), with family members being the most common source of support. Younger participants (19-38 years) showed higher internet use for health information compared to older participants. Participants independent in shopping functions showed greater interest in diverse health topics (foods, exercise, diseases, hospital information) and were more likely to use the internet for learning, getting health information, and watching videos. The correlation between functional independence and digital independence suggests that executive function—as demonstrated through everyday task performance—predicts technology adoption patterns.
Relevance
This research offers a paradigm shift for inclusive technology design by demonstrating that real-world functional abilities are more useful predictors of digital behavior than clinical classifications. For practitioners designing accessible digital health resources, the findings suggest that user profiling based on observable competencies (like shopping independence) can inform more targeted design decisions than IQ-based categories. The study highlights that adults with intellectual disability are interested in health information and capable of seeking it online when they have both the functional skills and appropriate support. The emphasis on video content preference among participants points to practical design implications—video-based health information may be more accessible than text. The finding that family support is crucial for internet access (33% relied on family versus 0% on librarians) underscores the need for designs that facilitate collaborative information-seeking rather than assuming independent use. However, the small sample size (39 participants) and focus on participants who could verbally communicate their experiences means findings may not generalize to all adults with intellectual disability.
Tags: intellectual disability · executive function · digital independence · functional independence · health information seeking · cluster analysis · inclusive design · user profiling